Athena Boolukos Gordon, EDM, PSYD
NPI 1700146552ActiveIndividual· Psychologist· Tampa, FL
Psychologist (EDM, PSYD) in Tampa, Florida, licensed in FL, with an NPI issued in May 2012. Medicare paid $6,922 for services to 32 patients in 2024.
Overview
| NPI | 1700146552 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | EDM, PSYD |
| Sole proprietor | No |
| NPI issued | May 25, 2012 |
| Last updated in NPPES | May 25, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | PY8510 | FL |
| Psychologist, Adult Development & Aging | 103TA0700X | PY8510 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 32 |
|---|---|
| Services billed | 119 across 3 procedure codes |
| Paid by Medicare | $6,922 |
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